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Longitudinal evaluation of criteria for subjective cognitive decline and preclinical Alzheimer's disease in a memory clinic sample.

Journal article
Authors Marie Eckerström
Mattias Göthlin
Sindre Rolstad
Erik Hessen
Carl Eckerström
Arto Nordlund
Boo Johansson
Johan Svensson
Michael Jonsson
Simona Sacuiu
Anders Wallin
Published in Alzheimer's & Dementia
Volume 16
Issue 8
Pages 96-107
ISSN 1552-5260
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Centre for Bone and Arthritis Research
Department of Psychology
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 96-107
Language en
Links dx.doi.org/10.1016/j.dadm.2017.04.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
https://gup.ub.gu.se/file/207557
Subject categories Neurochemistry, Neuroscience

Abstract

Subjective cognitive decline (SCD) and biomarker-based "at-risk" concepts such as "preclinical" Alzheimer's disease (AD) have been developed to predict AD dementia before objective cognitive impairment is detectable. We longitudinally evaluated cognitive outcome when using these classifications.Memory clinic patients (n = 235) were classified as SCD (n = 122): subtle cognitive decline (n = 36) and mild cognitive impairment (n = 77) and subsequently subclassified into SCDplus and National Institute on Aging-Alzheimer's Association (NIA-AA) stages 0 to 3. Mean (standard deviation) follow-up time was 48 (35) months. Proportion declining cognitively and prognostic accuracy for cognitive decline was calculated for all classifications.Among SCDplus patients, 43% to 48% declined cognitively. Among NIA-AA stage 1 to 3 patients, 50% to 100% declined cognitively. The highest positive likelihood ratios (+LRs) for subsequent cognitive decline (+LR 6.3), dementia (+LR 3.4), and AD dementia (+LR 6.5) were found for NIA-AA stage 2.In a memory clinic setting, NIA-AA stage 2 seems to be the most successful classification in predicting objective cognitive decline, dementia, and AD dementia.

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